In five-year strategy documents released Monday, the Obama administration announced plans to shift more overseas HIV/AIDS service delivery and day-to-day program management to recipient countries' health ministries. Many already are responsible for the delivery of services supported through the President's Emergency Plan for AIDS Relief (PEPFAR). However, with the exception of Rwanda and Namibia, none has "really developed the capability to oversee and manage these programs completely," said Dr. Eric Goosby, the US global AIDS coordinator.
Currently, much PEPFAR service delivery is accomplished through a multi-tiered system including US universities, international nonprofit organizations, government health ministries, and charities. The transition will involve teaching supply chain management, logistics, service coordination, program evaluation, and other skills. The United States, other international donors, and the Global Fund to Fight AIDS, TB and Malaria will continue to supply most of the funding.
"It is our honest belief that these programs are in a fragile period," said Goosby. "We need to transition them into being more embedded in the countries' infrastructure and for the countries to have true ownership of them."
The amount of PEPFAR funding through the next few years is uncertain. Last year, President Bush approved a bill authorizing up to $48 billion over five years to fight AIDS, TB and malaria. The portion for AIDS was $39 billion.
PEPFAR programs have mostly targeted 15 countries: 12 in sub-Saharan Africa plus Haiti, Guyana, and Vietnam. Some partner countries already are involved in the planned transitional efforts.
12/09/09
GLOBAL: US Seeking to Hand Off Oversight of AIDS Programs
Source: Washington Post:: David Brown; Courtesy of the CDC National Center for HIV, STD, and TB Prevention